Calling the Shots: Nursing News and Notes

A Prescription for Trouble

A Prescription for Trouble

Tuesday, January 19, 2016
What are dangers of overprescribing antibiotic medications?

Antibiotic prescribing rates

Every year at least 2 million people in the United States become infected with resistant bacteria, and at least 23,000 of them die as a direct result of the infection. Although some people are more likely to become infected with a resistant organism, everyone is at risk of developing antibiotic-resistant infections.

Losing effectiveness

Antibiotics and other antimicrobial agents have been prescribed for more than 70 years to treat infections, and they’ve greatly reduced illness and death from infections. However many times antibiotics are prescribed when they shouldn’t be. Moreover they’re often prescribed in incorrect doses for improper durations of time.

Developing resistance

What are the consequences of over prescribing antibiotics? Over prescribing antibiotics has caused the organisms to adapt and become resistant to the agents that were developed to kill them. When organisms develop resistance, antibiotics become less effective. 

Prescribing gone south

So, who is over-prescribing these antibiotic drugs? The Centers for Disease Control and Prevention (CDC) estimates that approximately half of all antibiotics prescribed in outpatient settings, such as clinics and physician offices are unnecessary. In an article published by the Washington Post, West Virginia had the highest antibiotic prescribing rate in 2014, at a rate of 1.24 prescriptions per person; more than double the rate of Alaska.

In fact, Americans living in the Southern states of Kentucky, Tennessee, Alabama, Mississippi, Arkansas, and Louisiana are prescribed more antibiotics than people who live in other areas of the country. Contrary to these states, U.S. citizens residing in the Western states have the lowest antibiotic prescription rates.

Consequences

Public health officials are very concerned about the possibility of microorganisms becoming resistant to antibiotic drugs.  As these organisms continue to change and evolve, if they mutate and become immune to the drugs, even minor infections could eventually become deadly.  As a result, it becomes more difficult to treat common conditions such as burns, trauma, and cancer, and particularly patients in need of organ transplants.

Thus, people who live in states where antibiotics are overprescribed are at increased risk for resistant infections. In addition to infections such as such as methicillin-resistant Staphylococcus aureus (MRSA), people who are prescribed antibiotics are also at risk for Clostridium difficile infection (CDI), which is directly associated with antibiotic use. In fact in about 20% of patients who develop CDI, the infection will resolve in 2 to 3 days of discontinuing the antibiotic.  However, Clostridium difficile has also changed over the past several years as a result of antibiotic overuse.  States have reported increased rates of CDI, reporting more severe disease and an increase in mortality.

Resistance fighters

So what can you do to fight resistance?

  • Reduce the use of antibiotics by taking measures to prevent infection.
  • Collect data on resistant organisms to identify causes of infection and people at risk for developing resistant infections.
  • Improve antibiotic prescribing by developing an antibiotic stewardship program.
  • Support new antibiotic development to keep up with resistant bacteria.

What is your facility doing to curb antibiotic use in your facility? What strategies have been successful? What have you learned from your experiences that you could share to help others curb antibiotic use?  Leave us a comment below. 

For more information, click HERE to check out our “Preventing Health-Care Associated Infections with Multidrug-Resistant Organisms” online course, which is accredited for 0.5 contact hours and part of the Lippincott Professional Development Collection online course library. 

 

 

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